Ex-top social care boss says ‘absolutely key’ next government prioritises sector

Lyn Romeo, who stepped down from her role as chief social worker for adults in England in January after 10 years, said reform of the sector has “always fallen at the hurdle of other pressures on money and budgets”.

Ms Romeo’s career has spanned five decades and her most recent role, the first of its kind, involved giving independent expert advice to ministers on social work reform.

Of the future for the sector, she said a sole focus on tackling problems in the NHS is not enough and that social care must be prioritised and seen as part of “our key civil infrastructure” in the way it is recognised, supported and valued.

Public satisfaction with social care services dropped to a new low in 2023, according to a survey published in March, while a report by the Public Accounts Committee that same month said plans had “once again gone awry”, with charging reform delayed, funding diverted, long waiting lists and workforce vacancies in excess of 150,000.

Steve Veevers, chief executive of learning disability charity Hft, has described a system “teetering on a cliff edge” and said that “without decisive action, the consequences will be dire for the millions who rely on these services”.

Providers, health think tanks and charities have criticised the main parties for a lack of focus on the sector in their manifestos.

While Liberal Democrat pledges on free personal care were hailed as ambitious and brave, the sums to make them happen “simply don’t add up”, health think tank the Nuffield Trust said.

The Conservatives were accused of restating old promises and making “vague pledges”, while Labour had come up with “a plan for a plan”, according to organisations within the sector.

Shadow health secretary Wes Streeting admitted at the weekend that he would have liked Labour’s manifesto – which pledged to work towards the creation of a National Care Service – to be “more ambitious” on social care.

In a rare interview since leaving her post, Ms Romeo told the PA news agency: “I think it’s absolutely key that the next government must prioritise (social care).

“I know there’s a big focus on the NHS but that will not be enough if they don’t, alongside of that, prioritise social care and getting social care on a sustainable footing and ensuring that people who need that care and support get it when they need it, and that it really does help them to live the lives that matter to them.”

Adult social care charging reforms – including an £86,000 cap on the amount anyone in England has to spend on their personal care over their lifetime – had been due to be implemented by the Conservative Government from October 2023 but were delayed by two years.

The Tories have pledged to stick with the timetable for bringing them in late next year, and while they were not mentioned in Labour’s manifesto, Mr Streeting has said they are part of his party’s plan.

Asked how important getting the care costs cap in place is, Ms Romeo said: “Well, you know, it’s been trailed for many, many years, hasn’t it?

“And I think it’s step one towards making a more sustainable and fairer system.

“But there’ll be many other things to consider.

“And it’s always fallen at the hurdle of other pressures on money and budgets.

“So, you know, ‘we’ll see’ is what my comment is, let’s see what happens.”

Particular areas in need of reform concern workforce pay, training and career pathways, she said.

Ms Romeo added: “And for us as a society to recognise this (social care) is part of our infrastructure, our key civil infrastructure, and we must recognise and support it and value it.”

While adult social care work requires a degree, work carried out by nursing home staff or domiciliary (home care) workers has never had the recognition it deserves, she said.

Describing it as “quite skilled work” involving good communication and managing “sometimes quite complex, conflictual situations in somebody’s home”, she said training and recognition of the efforts involved is crucial.

“People should get the right training to be able to do it well, but it’s never had the recognition it should have had, unlike nursing, for example,” Ms Romeo said.

The Conservative Government last year announced workforce reforms it said would help more people pursue careers in social care with nationally recognised qualifications, but campaigners have long said better pay is key.

In order to attract people into the sector, wages must allow them to live “reasonable lifestyles”, Ms Romeo said.

She told PA: “I’ve met some amazing care workers who do such amazing work and I’ve often said ‘Well, what happens around what you get paid?’ and they all say ‘Well obviously the pay is challenging’, but the sense of family and that kind of joy in working with people on a daily basis and creating that meaning for them is the main thing.

“But of course, if we want new, younger people to come in, then we do need to make it attractive because people need to be able to live.

“They need to be able to afford to eat and heat (their homes) and have a roof over their head.

“So it’s got to be able to allow people to have reasonable lifestyles. So it’s absolutely key.”

Asked for her message to young people considering their future career, she said: “If you’re interested in people, if you’re curious about them, if you want to make a real difference, then this is a career pathway that will give you that – over 50 years, which is where I’m up to, almost.

“And I’ve never regretted it once.”

The 68-year-old, who is originally from Australia but has lived in the UK for 44 years, described working in social care as “very, very rewarding and very, very interesting, albeit challenging and difficult”, but added: “If everything was easy, we wouldn’t find it that satisfying, would we?”